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General NPI Number Information
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NPI Number | 1417396409
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Entity Type | Individual
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Provider Name | ELENA FAITH WALKER M.A., LPCC
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Gender | Female
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Dates
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Enumeration Date | 06/23/2013
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Last Update Date | 12/15/2015
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Provider Practice Location Address
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Address Line | 1061 GRAND AVE
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City | SAINT PAUL
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State | MN
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Zip | 55105-3002
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Country | US
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Telephone | 651-212-4920
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Fax | 651-212-4795
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Provider Business Mailing Address
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Address Line | 3617 34TH AVE S
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City | MINNEAPOLIS
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State | MN
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Zip | 55406-2734
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Country | US
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Telephone | 612-723-2103
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | CC00399
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License Number State | MN
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